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Changes in Eating

http://vimeo.com/64112661

There are several factors that can affect your loved one’s ability to eat during cancer treatment. Some of these include:

  • Problems swallowing, which can be caused by pain or by the location of the tumor1Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.; researchers evaluated patients with oropharyngeal cancer before treatment and found that 67 percent had deficits in the ability to retract the tongue, 51 percent had decreased tongue strength and 40 percent had delayed swallowing2Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008 Feb;30(2):148-58.
  • Nausea and/or vomiting,which are often side effects associated with chemoradiation therapy3Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-353
  • Changes in the perception of taste or smell3, Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-3534Ogama N, Suzuki S. Adverse effects and appetite suppression associated with particle beam therapy in patients with head and neck cancer. Jpn J Nurs Sci. 2012 Jun;9(1):28-37.
  • Changes in salivation, such as decreased salivation or changes in the saliva quality2Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008 Feb;30(2):148-58.
  • Diarrhea3Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-353
  • Decreased appetite4Ogama N, Suzuki S. Adverse effects and appetite suppression associated with particle beam therapy in patients with head and neck cancer. Jpn J Nurs Sci. 2012 Jun;9(1):28-37.
  • Inflammation of the membranes in the mouth (mucositis)3, Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-3534Ogama N, Suzuki S. Adverse effects and appetite suppression associated with particle beam therapy in patients with head and neck cancer. Jpn J Nurs Sci. 2012 Jun;9(1):28-37.; severe mucositis sometimes causes pain, which in turn negatively impacts the desire to eat

Solutions for eating problems during cancer treatment

If your loved one experiences any of these problems and nutritional needs are not being met, there are various solutions a registered nutritionist and health care professionals may suggest, which are as follows:

  • Eat smaller meals more often.3, Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-3535Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74.
  • Eat or drink foods rich in nutrients.3, Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-3535Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74.
  • Obtain nutrients through a feeding tube or an IV. A nutritionist or other clinician may suggest this if your loved one loses 5% of their body weight within a one month time period, or 10% of their body weight within a six month period.1Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.
  • Manage treatment-associated side effects. For example, if your loved one has decreased salivation as a side effect of radiation therapy, report this symptom to a cancer care team member. The doctor, in turn, may recommend the use of a medication that can stimulate salivary production (e.g., pilocarpine).1Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

There may be a surgical remedy for long-term eating problems as well. Ask the care team if surgery is needed or might help.

The nurses and therapists were terrific at working with me and giving me exercises to learn how to swallow and speak again. Barry W. (palatomaxillary and low grade adenocarcinoma of minor salivary gland cancer survivor)

References

1 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

2 Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008 Feb;30(2):148-58.

3 Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-353

4 Ogama N, Suzuki S. Adverse effects and appetite suppression associated with particle beam therapy in patients with head and neck cancer. Jpn J Nurs Sci. 2012 Jun;9(1):28-37.

5 Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74.